Introduction: Racial and ethnic disparities in health outcomes, particularly in maternal mortality, have been highlighted in recent times. This issue demands a thorough analysis due to its profound social and medical implications. Evidence from public data in obstetrics and gynecology highlights a systemic bias that affects patient care. Beyond the well-known racial disparities, ethnic disparities in maternal mortality are also evident, as demonstrated by data from the National Center for Health Statistics in 2024. These disparities suggest that implicit biases, possibly linked to skin color, may influence healthcare outcomes. It is crucial to explore these biases to understand their impact on perinatal care Methods: A comprehensive literature review was conducted using the PubMed database, focusing on articles published between January 2020 and December 2024. The search targeted English-language manuscripts addressing racial and ethnic disparities in maternal mortality. A total of 243 articles were identified, and 64 were selected for detailed review based on their relevance and conclusiveness. Results: Analysis of the reviewed manuscripts revealed critical insights into maternal mortality disparities. Contrary to widely held beliefs that Black women face a three-fold greater risk of mortality during childbirth, the intersection of ethnicity and race (i.e., women of color) actually reveals a four-fold increased risk compared to white women. Furthermore postpartum hemorrhage (PPH) emerges as the leading cause of maternal mortality. The data also indicate that Black women are more frequently delivered via cesarean section than White women. Additionally, the increasing rates of cesarean deliveries have led to a higher incidence of uterine scarring, contributing to the development of placenta accreta spectrum (PAS), which may be exacerbating the rising incidence of PPH. These findings underscore the urgent need for targeted interventions to address these disparities and improve maternal outcomes. Discussion: It has been well-recognized that race and ethnicity, as social constructs, have little to do with any biological cause of maternal mortality. Reports suggest that disparities in maternal mortality, particularly among women of color, may be best explained by delays in providing optimal therapy for conditions like postpartum hemorrhage (PPH). Instead of biological differences, these disparities may be more closely related to implicit biases among healthcare providers, though research in this area is still developing. Therefore, it is crucial to focus our efforts on educating all healthcare professionals, including practicing physicians, nurses, and medical students, to address and rectify these disparities. By fostering a more equitable healthcare environment, we can work towards significant improvements in maternal health outcomes across diverse populations.
Levine et al. (Sat,) studied this question.